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Comparison of 3D magnetic resonance imaging and digital subtraction angiography for intracranial artery stenosis

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Abstract

Objectives

To compare three-dimensional high-resolution magnetic resonance imaging (3D HR-MRI) and digital subtraction angiography (DSA) for diagnosing and evaluating stenosis in the entire circle of Willis.

Methods

The study included 516 intracranial arteries from 43 patients with intracranial artery stenosis (ICAS) who underwent both 3D HR-MRI and DSA within 1 month. Two readers independently diagnosed atherosclerosis, dissection, moyamoya disease and vasculitis, rated their diagnostic confidence for each vessel and measured the luminal diameters. Reference standard was made from clinico-radiologic diagnosis. Diagnostic accuracy, diagnostic confidence, the degree of stenosis and luminal diameter were assessed and compared between both modalities.

Results

For atherosclerosis, 3D HR-MRI showed better diagnostic accuracy (P = .03–.003), sensitivity (P = .006–.01) and positive predictive value (P ≤ .001–.006) compared to DSA. Overall, the readers were more confident of their diagnosis of ICAS when using 3D HR-MRI (reader 1, P ≤ .001–.007; reader 2, P ≤ .001–.015). 3D HR-MRI showed similar degree of stenosis (P > .05) and higher luminal diameter (P < .05) compared to DSA.

Conclusions

3D HR-MRI might be useful to evaluate atherosclerosis, with better diagnostic confidence and comparable stenosis measurement compared to DSA in the entire circle of Willis.

Key Points

• 3D HR-MRI showed better diagnostic accuracy for atherosclerosiscompared to DSA

• 3D HR-MRI showed better overall diagnostic confidence for stenosiscompared to DSA

• 3D HR-MRI and DSA showed similar degree of stenosis

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Abbreviations

2D:

two-dimensional

3D:

three-dimensional

DSA:

digital subtraction angiography

GEE:

generalized estimating equation

HR-MRI:

high-resolution magnetic resonance imaging

ICAS:

intracranial artery stenosis

PPV:

positive predictive value

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Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Ji Eun Park, Seung Chai Jung, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim & Deok Hee Lee

  2. Department of Neurology, University of Ulsan College of Medicine, Ulsan, South Korea

    Sang Hun Lee, Sun U. Kwon, Dong-Wha Kang & Jong S. Kim

  3. Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea

    Ji Young Jeon

  4. Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, 420-767, Korea

    Ji Ye Lee

  5. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seon-Ok Kim

Authors
  1. Ji Eun Park
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Corresponding author

Correspondence to Seung Chai Jung.

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Guarantor

The scientific guarantor of this publication is Sang Joon Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This research was supported by the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare, and Family Affairs, Republic of Korea (grant number -HI12C1847).

Statistics and biometry

One of the authors has significant statistical expertise (Seon-Ok Kim).

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was waived by the institutional review board.

Methodology

  • retrospective

  • diagnostic study

  • performed at one institution

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Park, J.E., Jung, S.C., Lee, S.H. et al. Comparison of 3D magnetic resonance imaging and digital subtraction angiography for intracranial artery stenosis. Eur Radiol 27, 4737–4746 (2017). https://doi.org/10.1007/s00330-017-4860-6

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  • DOI: https://doi.org/10.1007/s00330-017-4860-6

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